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Background: Patients with Barrett's oesophagus (BO) carry significant cancer worry, burden of symptoms, and lack disease-specific knowledge. Currently there is no validated BO patient reported outcome measure (PROM) to measure these factors for use in clinical practice and research, hence the aim of this study was to devise a novel, validated BO-specific tool, B-PROM. Methods: Literature review, quantitative and qualitative research informed the initial item generation. The item bank was refined through a modified Delphi process between May and August 2021. The PROM was then tested through cognitive interviews and validated via multicentre testing between September 2021 and February 2023 with the aim to create a succinct tool which addresses the key important factors to BO patients and has strong psychometric properties. Findings: B-PROM covers key themes of disease-specific knowledge, trust in clinicians, burden of symptoms, cancer worry and burden of surveillance. Validation results from 387 participants (response rate 40.8%) showed 93.3% of participants completed >95% of B-PROM. All individual items scored a completion rate of >95%. Mean completion time was 5 mins 34s for a sample group. Nineteen items showed a ceiling effect, 3 items showed a floor effect. Internal consistency overall demonstrated a Cronbach Alpha of 0.846, while predetermined subsections showed Cronbach alphas of 0.335, 0.718, 0.736, and 0.896. Inter-item analysis found 2 pairs of items with strong correlation, with only 6 items correlating weakly. Item-total correlation showed 19 items correlated well. Exploratory Factor analysis (EFA) with principal component analysis produced 5 components with Eigenvalues >1 of which 4/5 had satisfactory Cronbach alphas. Test-retest reliability showed no significant differences across single and average measures (p ≤ 0.001). Interpretation: B-PROM is the first BO-specific PROM to be systematically evaluated. Validation findings show strong internal consistency, short completion time, low missingness and excellent test-retest reliability. Funding: Medtronic Limited ISR-2016-1077.
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Introducción: El trastorno de ansiedad generalizado (TAG) es una entidad clínica caracterizada por preocupación excesiva y no controlada que puede causar discapacidad funcional, durante un período mínimo de 6 meses. La prevalencia global de TAG en las pacientes en estado de gestación es de 8.5% a 10.5%, la cual es mayor en comparación a la población general (reportada de 1.2% a 6.4%). Entre los factores de riesgo se incluyen: bajo nivel educacional y socioeconómico, pobreza, desintegración familiar, etc. Se ha reportado como complicaciones de TAG durante el embarazo: incremento de consumo de alcohol, riesgo de parto pre término, bajo peso al nacer, etc. Objetivo: Determinar la prevalencia de trastorno de ansiedad generalizada según el trimestre de embarazo en mujeres gestantes de San Juan Sacatepéquez ya que no existen datos de dicha población. Metodología: Se empleó la escala GAD-7. Se escogió como población a pacientes que asistieron a la consulta externa del Centro de Salud Bárbara durante el mes de junio del 2018. Resultados: La prevalencia de TAG hallada fue: 7.40% en el primer trimestre, 8.82% en el segundo trimestre y 7.31% en el tercer trimestre. Palabras Clave: Ansiedad generalizada, embarazo GAD-7.
Introduction: Generalized anxiety disorder (GAD) is a clinical entity characterized by excessive and uncontrolled worry that can lead to functional disability, for a minimum period of 6 months. The global prevalence of GAD in pregnant patients is from 8.5% to 10.5%, which is higher compared to the general population (reported from 1.2% to 6.4%). Risk factors include: low educational and socioeconomic level, poverty, family disintegration, etc. It has been reported as complications of GAD during pregnancy: Increased consumption of alcohol, risk of preterm birth, low birth weight, etc. Objective: To determine the prevalence of generalized anxiety disorder according to the trimester of pregnancy in pregnant women from San Juan Sacatepéquez, since there are no data for this population. Methodology: the GAD-7 scale was used. Patients attending the outpatient clinic of the Barbara Health Center were selected as a population during the month of June 2018. Results: The prevalence of GAD found was: 7.40% in the first trimester, 8.82% in the second trimester and 7.31% in the third trimester. Keywords: General anxiety, pregnancy, GAD-7
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BACKGROUND: A serious board game called 'FREDA Challenge' was co-produced with people with intellectual disabilities (PWID) as a tool for human rights (HR) education and increase positive attitudes towards HR in healthcare settings. The current study evaluated 'FREDA Challenge' with PWID and their carers. METHOD: Eighteen PWID and 13 carers participated in a repeated measures design whereby changes in attitudes and knowledge of HR were measured. RESULTS: Analysis revealed statistically significant differences (P = 0.02) between PWID and carers in their knowledge of HR. The same was not evident for attitudes towards HR. The positive attitudes and knowledge in the PWID group significantly increased after playing the game (P ≤ 0.02), but not for the carers/professionals group. CONCLUSIONS: Findings suggest that playing the board game can positively change the attitudes and knowledge of PWID towards HR. The board game seems to elicit positive interpersonal dynamics between PWID and carers/professionals.